I am in my late second trimester of my second pregnancy. I had pre-eclampsia and HELLP with my first, thankfully with a happy outcome (healthy baby girl of 2 years now!). I am experiencing symptoms exactly like my first time, which includes general malaise, dizziness, and upper right quadrant pain (occasional vomiting returning as well). I know this is atypical, but both times, I have had weeks of somewhat mild URQ pain with my liver enzymes remaining normal. Last time, the liver enzymes went up very quickly just before I delivered, despite having had the pain for months. My liver enzymes are currently still normal, and I am going on about 4 weeks of this relatively mild pain. BP is slightly up for me, but not to problematic levels yet. Has anyone else had such a slow onset, including URP pain without corresponding immediate rise in the liver enzymes? Thanks for your input.

Most information out there seems to indicate that HELLP presents very suddenly, but I seem to recall some posts from others in this forum who developed their symptoms over several weeks. How often are you having your blood checked? I would probably be in L&D every day with those symptoms, just to be safe! I'll keep my fingers crossed for you.

Thanks for the crossed fingers I am getting my enzymes checked at each 2-week appointment. My bp started going up a little more yesterday with ringing in my ears and more vomiting. Since this did present slowly for me last time, I am hopeful that I can wait it out until my next appointment in a few days. It is really hard to know at what point I should be concerned, though!

Since you are noticing an increase in symptoms I'd call the doc after hours. Or go to L &D to get checked out. Even if they don't want you to get checked out tonight they might want to move your appointment up.

Vomiting in late pregnancy always scares me. Especially with your history better safe than sorry!

Update: My liver enzyme/platelet numbers continue to be in the safe range, which is wonderful news. My blood pressure, however, shot up over the weekend, so I may be headed into preeclampsia land. I have read that you are more likely to have pre-e for the second pregnancy than to have a HELLP recurrence, so it is not terribly surprising. I have another appointment tomorrow and have been trying to take it easy, so I am hoping my bp goes back down...

I had HELLP with a liver rupture with my first pregnancy and post-partum Preeclampsia with my second pregnancy. Throughout my second pregnancy I had upper right quadrant pain that was severe enough to make me go to the hospital a few times. My liver enzymes were always normal and no protein in my urine. I had a scheduled c-section at 40 weeks and thought I was in the clear until my pulse dropped and bp shot up after I had been released from the hospital. I went back to the hospital and was re-admitted. Four days later I finally convinced them that I was developing post-partum PreE and they started mag. I felt better almost immediately.

All this to say, be on guard and don't be afraid to have your blood drawn each week. It will ease your mind to know that your enzymes are normal! Also, you know your body and if something isn't right please call your doctor. Better to over test in my opinion and have a happy, healthy outcome!

Laura, thank you so much for sharing this; it was exactly what I needed to hear. Sometimes you feel a little crazy still telling the doctor that something hurts when the numbers don't back it up yet. It's good to know that I'm not the only one who has had an experience with symptoms like this, and it sound like it is smart for me to still be watchful. Thank you for the encouragement!

If the URQ pain gets dramatically worse again and/or I have a reading of 140/90 or higher, I am supposed to go to L&D. The URQ pain comes and goes for me, so it is hard to gauge from that alone. I plan to at least call her office if something doesn't feel right. She is still going to run labs at each appointment to keep an eye out for changes, which makes me feel a bit better...

How are you doing? I limped along with transient URQ pain for a few weeks before my liver enzymes spiked up. I don't think that the pain changed all that much, but I started to have serious nausea and vomiting when things got bad. I would watch out for any worsening symptoms or new symptoms and go in immediately if something changes. I hope you can hang in there for a while.